Fluids Balance Charts: improving completion and accuracy

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Background & Problem

Fluid balance is a term described as the balance of the input and output of fluids in the body to allow metabolic processes to function correctly. It is an essential tool to determine hydration status.

Hypovolemia and hypervolemia can increase mortality and morbidity. Therefore, the accuracy in recording fluid intake and output is vital for the management of certain patients.

This assessment has frequently been poorly documented on Lilleybrook Ward which is why we decided it needed to be corrected.

Aim

To achieve 90% completion and accuracy of fluids balance charts by 1st April 2019.

Method

We provided training to all the nursing staff involved in the monitoring of the fluid balance charts (FBCs) and after that we audited the FBCs once a week for 26 weeks.

We also created a poster that was placed in the kitchen area, the staff room and the staff toilet.

Results

During a period of 26 weeks we monitored the fluids balance charts on the ward once weekly. The completion and accuracy improved for the first few weeks, achieving a stable period after week 10-12.

We have achieved 94.5% completion and accuracy of the fluids balance charts on the ward.

Implications

The FBCs were not completed correctly possibly due to lack of understanding or bad habits of not completing them correctly and accurately. After training the nursing staff and monitoring the FBCs, the process has greatly improved and we are aiming to maintain those results, so we will monitor the FBCs monthly, training new staff when they start as well as providing regular training when required.

This could potentially be extended to all the wards in GHNHSFT that are experiencing the same problem.